Miura Ken, Nagaoka Tomoko, Ikeda Ken, Hirayama Takehisa, Kawabe Kiyokazu, Iwasaki Yasuo
Department of Neurology, Toho University Omori Medical Center, Japan.
Intern Med. 2012;51(8):921-4. doi: 10.2169/internalmedicine.51.6867. Epub 2012 Apr 15.
We report a patient with partial oculomotor paresis due to midbrain infarction. A 69-year-old man noticed diplopia suddenly. Ptosis, and impaired adduction and supraduction were found in the right eye. The pupillary size and light reflexes were normal on both sides. Magnetic resonance imaging disclosed an acute lesion in the right inferolateral oculomotor fascicle. These clinicoradiological findings suggested that the inferolateral fascicular damage could cause palsy of the levator palpebrae, medial rectus, superior rectus and inferior oblique muscles. Physicians should pay more attention to oculomotor fascicular infarction in patients with incomplete oculomotor paresis, and spared pupil sphincter and inferior rectus muscles.
我们报告一例因中脑梗死导致部分动眼神经麻痹的患者。一名69岁男性突然出现复视。右眼存在上睑下垂、内收和上转功能障碍。双侧瞳孔大小及光反射正常。磁共振成像显示右侧动眼神经下外侧束有急性病变。这些临床影像学表现提示动眼神经下外侧束损伤可导致提上睑肌、内直肌、上直肌和下斜肌麻痹。医生应更加关注动眼神经束梗死患者出现不完全动眼神经麻痹,且瞳孔括约肌和下直肌未受累的情况。